新人999过敏性鼻炎该如何治疗配图，仅供参考
Symptomatic Therapies in Allergic RhinitisPharmaceutical management of AR rests on symptomatic treatments with antihistamines,nasal or oral glucocorticoids,nasal decongestants and leukotriene receptor antagonists that act as symptoms reliever in AR. Antihistamines is the most utilized first line medication to treat mild AR,however,first generation of antihistamines (e.g.,diphenhydramine and hydroxyzine) are no longer recommended due to various adverse side effects impacting the central nervous system,anticholinergic side effects and cardiac toxicity ). Newer generation of antihistamines (e.g.,cetirizine,loratadine,desloratadine,fexofenadine,rupatadine,and bilastine) should be chosen as they demonstrate enhanced efficacy and safety profile ). A newer type of intranasal antihistamine (e.g.,olopatadine,levocabastine,and azelastine) ensures improved drug delivery to nasal mucosa exposed to release mediators during allergic inflammation in AR ).
Besides,intranasal corticosteroid that acts as first-line pharmacotherapy by suppressing immune cells infiltration in AR is effective for both mild and moderate-severe AR in both children and adults ). Currently approved intranasal corticosteroid for children are mometasone furoate (≥3 years old),fluticasone propionate (≥4 years old),triamcinolone acetonide (≥4 years old) and ciclesonide (≥6 years old) ). A meta-analysis study was conducted to determine which combination therapies resulted in improved symptoms in AR patients. The meta-analysis demonstrated that intranasal H1 antihistamines and intranasal corticosteroids combination therapies were better compared with oral H1 antihistamines plus intranasal corticosteroid combination therapies ).
Next,leukotriene receptor antagonists (e.g.,montelukast,zafirlukast,and pranlukast) block the activity of cysteinyl leukotrienes,an important potent allergic mediator that causes allergic inflammation and various allergic symptoms such as nasal congestion and mucus production ). A meta-analysis study showed higher efficacy of leukotriene receptor antagonist compared with H1 antihistamines during nighttime symptoms but not in daytime symptoms ). Other meta-analysis studies demonstrated that combination therapy of leukotriene receptor antagonist plus H1 antihistamines conferred increased efficacy in reducing daytime symptoms ).
Treatment using nasal decongestants reduces nasal congestion symptoms through their agonistic action at α1 and α2-adrenergic receptors on endothelial cells of nasal mucosa,leading to reduced mucosa swelling ). Available nasal sprays in stores are oxymetazoline (Afrin),phenylephrine (Neo-synephrine) and pseudoephedrine (Sudafed). Overuse of nasal decongestants can cause rhinitis medicamentosa (i.e.,a condition of rebound congestion upon withdrawal of nasal decongestants) ) and this condition can be treated by administering intranasal corticosteroid ).","department":"
